Imagine that you’ve got a middle school daughter who is confused — is she really a boy? She wants help blocking out the noise, help affirming what she used to know for certain. Not quite knowing what to do, you find a therapist.

It turns out, however, that you live in one of the many places — from Virginia to Illinois, from Kansas City, Missouri, to Columbus, Ohio — that prohibit therapists from telling your daughter the truth: She is a girl. A wave of cities and states have banned what they call “conversion therapy” for LGBT people over the past several years. My city, Cleveland, passed a ban just last week. The newspaper headlines bring to mind an end to lobotomies, electric shock therapy, or aversion training impossibly geared to change the sexual preferences of gay men in the 20th century.

But why, in 2022, would these jurisdictions waste their time banning medical practices that no longer exist? Does the Cleveland Clinic have a secret basement we don’t know about? No. The bans aren’t about ending medical carnage. They are bans on speech and bans on the truth.

Take Cleveland’s ban, which mimics that of other cities. It said that “no mental health professional” shall engage in “gender identity or expression change efforts with a minor.” This applies to “talk therapy.” But the ordinance allows “psychotherapies or therapeutic activities that provide acceptance” for a minor’s professed gender identity.

Far from banning conversion therapy as we used to understand that term, these laws are conversion mandates. Under these so-called conversion therapy bans, therapists may not tell their patients the scientific truth. Instead, they are required to participate in the psychological conversion of boys into girls and girls into boys.

The First Amendment prohibits government actors, including state and local governments, from “abridging the freedom of speech.” There are, of course, some exceptions. Content-neutral speech restrictions are sometimes permissible. City ordinances that regulate noise, for example, have nothing to do with prohibiting a certain message, and courts have allowed these regulations even though they technically reduce speech. But youth conversion mandates are rooted entirely in the content and viewpoint of the therapist’s speech: One viewpoint is banned, while another is permitted. That is a core First Amendment violation.

One appellate court has already struck down conversion mandates in Florida, Georgia, and Alabama precisely because the First Amendment does not permit them. The U.S. Court of Appeals for the 11th Circuit reasoned that if cities could lawfully ban biological sex-affirmation discussions, then cities could also ban gay pride discussions or those about a host of other therapeutic topics on which citizens, and therapists, might differ. The First Amendment forbids the government from shutting these conversations down.

Sadly, America may soon find whole categories of speech off-limits. One way to slow this anti-democratic trend is to stop using the language of the censors. These state laws and city ordinances do not prohibit “conversion therapy” — they require it. And they prohibit therapists from speaking the scientific truth.

Words matter.